Pathology Trends

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Pathology groups face a number of challenging pathology trends in the era of radical healthcare reform.

One of the primary trends is that like clinical laboratories, these businesses are carrying significant and potentially unsustainable levels of unreimbursed services. Although bad debt and uncompensated care in the healthcare industry are not new, they have been increasing at the same time that downward pressure is being applied to pathology reimbursement.

Medical laboratories and pathology groups are also facing enormous levels of change in their clinical, regulatory and financial environments. As the Affordable Care Act is implemented, laboratories see downward pressure on reimbursement at both the federal and payer level, coupled with increased emphasis on efficiency and quality.

Labs and health care providers need to seriously consider moving toward a retail business model. Changes in the health insurance market are now requiring patients to pay more out of pocket, and the perfect storm of bad debt and decreased requirement is pressuring laboratories.

Other pathology trends include:

  • Growing emphasis on the continuum of care
  • Increasing patient interaction directly with the lab organization
  • Mounting demands of interoperability across a proliferation of disparate information technology systems to achieve meaningful use
  • Evolving requirements for communication and data sharing with payers, accountable care organizations (ACOs), health information exchanges (HIEs) and other trading partners
  • Industry observers say that responding to each of these trends requires access to the most complete set of patient data possible. Accurate patient identification and record consolidation is central to achieving these goals.

    In addition, labs and pathologists are increasingly urged to add value to the testing services they perform by leveraging information technology. For instance, advanced health information technology can be deployed within clinical labs and pathology groups specifically to meet changing patient expectations, while supporting the needs of client physicians for optimal workflow.

Despite Tough Anatomic Pathology Market, Bostwick Opens New Laboratory

CEO SUMMARY: Once again, entrepreneur and pathologist David G. Bostwick, MD, is starting up a new lab company. Granger Diagnostics is now open and is located in North Chesterfield, Virginia. It is designed to be an anatomic, clinical, and molecular pathology reference laboratory. In an exclusive interview, Bostwick identified three substantial changes that have happened

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NeoGenomics to Acquire Clarient for $275 Million

CEO SUMMARY: In a surprise move that further consolidates national anatomic pathology services, NeoGenomics will acquire Clarient Inc., from General Electric Healthcare. General Electric is getting cash, and preferred and common stock. The two companies announced plans to pursue integrated diagnostic services that would combine lab testing and diagnostic imaging data. The deal is subject

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Pathologists Contribute To Care in Wisconsin ACO

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CEO SUMMARY: From the launch in 2013 of a big accountable care organization in Wisconsin, the North Shore Pathologists at Columbia-St. Mary’s Hospital have been involved. Among the lessons learned are the importance of structuring the pathology contract with the hospital to anticipate value-based reimbursement and having full access to the ACO’s data. The pathologists are using this data to develop test utilization programs that help physicians order the right lab test for the right patient.

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Early ACO Experience Has Lessons for Pathologists

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CEO SUMMARY: To date, many of the nation’s 500 accountable care organizations have launched with little involvement by independent pathology groups and clinical laboratories. That was not the case with an ACO in Alabama, however. From its inception in 2012, the ACO has contracted with CytoPath, P.C., a five-pathologist group in Alabaster, Alabama. CytoPath’s pathologists are currently paid on a fee-for-service basis and must provide detailed and timely data to the ACO.

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UCLA Pathologists, Radiologists Produce Combined Reports

David Geffen School of Medicine logo - diagnostic labs

CEO SUMMARY: To simplify diagnostic reporting, the pathology and radiology departments at the David Geffen School of Medicine/UCLA Medical Center are working together to deliver integrated diagnostic information to treating oncologists. This innovative strategy is designed to improve patient care and quality while saving time and cutting costs. For five months, diagnosticians have worked together on more than 50 lung cancer cases while gathering the evidence to show this interdisciplinary approach can improve decision making and reduce downstream treatment costs.

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